{"id":2360,"date":"2014-09-23T19:36:49","date_gmt":"2014-09-23T19:36:49","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/endss\/"},"modified":"2026-04-08T20:16:58","modified_gmt":"2026-04-08T20:16:58","slug":"endss","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/endss\/","title":{"rendered":"Diagnostic Criteria for Serotonin Syndrome (SS)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Serotonin syndrome is a potentially life-threatening condition resulting from increased CNS serotonergic activity that is usually drug related. Symptoms may include mental status changes, hyperthermia, and autonomic and neuromuscular hyperactivity.<br \/>\n<!--more--><br \/>\n<strong>Diagnostic Criteria for Serotonin Syndrome (SS)<\/strong><br \/>\n<strong>\u00a0<\/strong><br \/>\n<strong>Sternbach\u00b4s Criteria<\/strong><br \/>\nMust have recent addition of known\u00a0<span style=\"line-height: 1.3em;\">serotonergic agent, absence <\/span><span style=\"line-height: 1.3em;\">of other causes, and no recent <\/span><span style=\"line-height: 1.3em;\">addition of a neuroleptic agent <\/span><span style=\"line-height: 1.3em;\">and must exhibit at least 3 of the <\/span><span style=\"line-height: 1.3em;\">following:<\/span><\/p>\n<ul>\n<li><span style=\"line-height: 1.3em;\">Mental status changes<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Agitation<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Hyperreflexia<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Myoclonus<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Diaphoresis<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Shivering<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Tremor<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Diarrhea<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Incoordination<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Elevated temperature<\/span><\/li>\n<\/ul>\n<p><span style=\"line-height: 15.8079996109009px;\"><strong>Radomski\u00b4s Criteria<\/strong><\/span><br \/>\nMild state:<\/p>\n<ul>\n<li><span style=\"line-height: 1.3em;\">Restlessness<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Insomnia<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Incoordination<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Dilated pupils<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Akathisia<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Tachycardia<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Tachypnea\/dyspnea<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Diarrhea<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Autonomic instability<\/span><\/li>\n<\/ul>\n<p style=\"line-height: 15.8079996109009px;\">Severe state:<\/p>\n<div>\n<ul>\n<li><span style=\"line-height: 15.8079996109009px;\">Impaired level of <\/span><span style=\"line-height: 1.3em;\">consciousness<\/span><\/li>\n<li><span style=\"line-height: 15.8079996109009px;\">Elevated mood<\/span><\/li>\n<li><span style=\"line-height: 15.8079996109009px;\">Coma<\/span><\/li>\n<li><span style=\"line-height: 15.8079996109009px;\">Myoclonus<\/span><\/li>\n<li><span style=\"line-height: 15.8079996109009px;\">Tremor<\/span><\/li>\n<li><span style=\"line-height: 15.8079996109009px;\">Shivering<\/span><\/li>\n<li><span style=\"line-height: 15.8079996109009px;\">Rigidity<\/span><\/li>\n<li><span style=\"line-height: 15.8079996109009px;\">Hyperreflexia<\/span><\/li>\n<li><span style=\"line-height: 15.8079996109009px;\">Hyperthermia<\/span><\/li>\n<li><span style=\"line-height: 15.8079996109009px;\">Sweating<\/span><\/li>\n<\/ul>\n<\/div>\n<p><span style=\"line-height: 15.8079996109009px;\"><strong>Hunter\u00b4s Criteria<\/strong><\/span><br \/>\nMust have taken a serotonergic\u00a0<span style=\"line-height: 1.3em;\">agent and meet one of the <\/span><span style=\"line-height: 1.3em;\">following criteria:<\/span><\/p>\n<ul>\n<li><span style=\"line-height: 1.3em;\">Spontaneous clonus<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Inducible clonus plus agitation <\/span><span style=\"line-height: 1.3em;\">or diaphoresis<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Ocular clonus plus agitation or <\/span><span style=\"line-height: 1.3em;\">diaphoresis<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Tremor plus hyperreflexia<\/span><\/li>\n<li><span style=\"line-height: 1.3em;\">Hypertonia plus temperature <\/span><span style=\"line-height: 1.3em;\">higher than 38 \u00b0C plus ocular <\/span><span style=\"line-height: 1.3em;\">clonus or inducible clonus<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med. 2005 Mar 17;352(11):1112-20.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15784664\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Cooper BE, Sejnowski CA. Serotonin syndrome: recognition and treatment. AACN Adv Crit Care. 2013 Jan-Mar;24(1):15-20.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/23343808\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Iqbal MM, Basil MJ, Kaplan J, Iqbal MT. Overview of serotonin syndrome. Ann Clin Psychiatry. 2012 Nov;24(4):310-8.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/23145389\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Prakash S, Shah CS, Prakash A. Serotonin syndrome controversies: A need for consensus. World J Crit Care Med. 2024 Jun 9;13(2):94707. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38855279\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Oct 07, 2014.<br \/>\nUp-date Apr 08, 2026.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[76],"tags":[16,15,14,13,895,894,5,842,4],"class_list":["post-2360","post","type-post","status-publish","format-standard","hentry","category-psychiatry","tag-criteria","tag-criterios","tag-diagnostic","tag-diagnostico","tag-serotonin","tag-serotoninergico","tag-sindrome","tag-ss","tag-syndrome"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2360","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2360"}],"version-history":[{"count":4,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2360\/revisions"}],"predecessor-version":[{"id":10739,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2360\/revisions\/10739"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2360"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2360"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2360"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}